Financial Considerations

Liver Transplant Medication Costs

One of the important things that you should consider when deciding on whether you want a liver transplant is the cost of the medications you must take after your liver transplant. In order for you to keep your new liver healthy you will need to take medications for the rest of you life.

This list is to serve as an approximate cost and dosage of Post-Transplant Medications. The cost of each medication may vary from one pharmacy to another. In addition to the variation in cost, each person's dosage may be different. As a patient you may also be on other medications i.e. High Blood Pressure medication, Insulin, etc. that you will need to purchase in addition to the medications listed below:

 

Medication Cost
Prograf 5 mg. BID $1000 month
Neoral 400 mg. BID $1500 month
Cellcept 1000 mg. BID $620 month
Deltasone tapered dose $30 month
Cytovene 500 mg. BID $430 month
Bactrim SS or Single Strength $42 month
Trimeth Sulfa Generic Bactrim SS $10 month
Myclex Troche TID $110 month
Prevacid 30 mg Daily $130 month
Pericolace Over the Counter Drug $13 month
Multivitamin Over the Counter Drug $7 month

 

As you can see, these post-transplant medications are costly. You should check your prescription coverage to find out what your co-pay is for both the generic and the brand name drugs. Please remember than what sounds like a low co-pay can in actuality be a $400 + pharmacy bill a month. It is important that you know what you will be responsible for paying each month.

Check with your prescription plan and find out if you have a mail order prescription drug plan. The advantage to this is you generally receive 90 days of medication with your co-pay instead of the 30 days of medication that you receive at your local pharmacy. Remember that not every prescription plan is the same. It is important that you find out what benefits you have with your prescription plan.

Additional Information

Medicare - If you are currently enrolled in Medicare or will have Medicare at the time of your transplant you have 80% prescription coverage for your anti-rejection drugs (i.e. Prograf, Neoral, Cellcept and Deltasone). However, Medicare currently covers anti-rejection medications for only 3 years and 8 months. You will need to have a secondary insurance plan to cover the remaining 20% co-pay for these medications. If you do not have a secondary insurance plan you will be responsible for paying the 20% co-pay to your pharmacy.

Your pharmacy must participate with Medicare in order for you to get the 80% prescription coverage. If your pharmacy does not participate with Medicare your transplant social worker can assist you in finding a Medicare participating pharmacy.

After 3 years and 8 months all coverage of medication ends. You will need to have a plan for how you will pay for your medications.

When Medicare Ends and/or You Lose Your Prescription Coverage

There are only a few options available to patients who no longer have Medicare coverage for their anti-rejection medications or lose their prescription coverage:

 

  • You are able to obtain prescription coverage through an employer Group health plan. You may need to return to work or you may need to obtain prescription coverage through your spouse.
  • You are 65 years of age or older and are eligible for PACE/PACE NET - 800-225-7223
  • You are eligible for medical care through the Veterans Administration. In order to receive prescription coverage you must be under the treatment of a VA physician. 800-409-8771 ext. 6000
  • You financially qualify for a Patient Assistance Program through a drug company.
    • Novartis (Neoral) 800-257-3273
    • Fuijisawa (Prograf) 800-477-6472
    • Roche (Cellcept/Cytovene) 800-772-5790
    • Wyeth-Ayerst (Rapamune) 800-472-7268
    • Glaxo-Welcome (Imuran) 800-722-9294
    • Upjohn (Deltasone) 800-242-7014

You should be aware that if you have any insurance coverage you will not be able to obtain your medications from these Patient Assistance Programs.

These documents (created by and for the express use of the Penn State Milton S. Hershey Medical Center, Transplantation Program) serve as a tool for transplant patients. If you wish to have additional copies please contact:

 

  • Gail L. Flannery, L.S.W.
    Phone: 717-531-3985
  • Ann E. MacLaughlin, B.S.W .
    Phone: 717-531-6316